Global Burden of Cardiovascular Diseases

In recent years, the dominance of chronic diseases as major contributors to total global mortality has emerged and has been previously described in detail elsewhere. By 2005, the total number of cardiovascular disease (CVD) deaths (mainly coronary heart disease, stroke, and rheumatic heart disease) had increased globally to 17.5 million from 14.4 million in 1990. Of these, 7.6 million were attributed to coronary heart disease and 5.7 million to stroke. More than 80 percent of the deaths occurred in low and middle income countries (WHO, 2009e).

Based on 2007 to 2010 data, 33% of US adults ≥ 20 years of age have hypertension. This represents ~ 78 million US adults with hypertension. The prevalence of hypertension is similar for men and women. African American adults have among the highest prevalence of hypertension (44%) in the world.

New sound synchronization technology holds the key to earlier diagnosis of heart disease

Jun 02, 2011 Viewed: 358

Innovative UK technology is contributing to the development of a revolutionary digital stethoscope that could make it easier for GPs to spot the first signs of heart disease.

With Engineering and Physical Sciences Research Council (EPSRC) funding, a Queen Mary, University of London (QMUL) team has developed a computer-based technology that synchronises the various sounds collected by the new stethoscope and which make up a human heartbeat.

The sounds can then be analysed by an existing technique called ICA (independent component analysis), with data presented on a laptop or desktop computer in easy-to-understand graphs. These provide a visual representation of the heartbeat and any anomalies in it. Currently, such anomalies can be missed by doctors who aren’t experts in cardiac care.

ICA can only analyse heartbeats if all the different sounds that make up an individual’s heartbeat are brought together as one overall sound.

Like a conventional stethoscope, the new stethoscope captures four sounds one after another. The computer-based technology developed by the QMUL team then turns these separate sounds into one combined signal which ICA can then process. The QMUL synchronisation technology therefore plays a vital bridging role between the new stethoscope and ICA.

With conventional stethoscopes, the identification of a potential heart problem is completely reliant on the expertise and listening skills of the GP.

QMUL’s technology was unveiled on 25th May at the 36th International Conference on Acoustics, Speech and Signal Processing held in Prague in the Czech Republic.

The overall stethoscope development project is an international collaboration led by Portugal’s University of Porto and Centro Hospitalar Alto Ave, Guimarães.

“Heart disease is still the UK’s number-one killer”, says Professor Mark Plumbley, who has led the QMUL work. “Our work here is making a vital contribution to an invention that will help GPs identify heart problems before they become serious – even when patients come to surgery about a totally unrelated health matter. Early interventions not only help patients but also reduce the burden on healthcare resources.”

As well as being suitable for use in GP surgeries, the stethoscope – called the DigiScope – will be ideally suited to outpatient clinics, accident & emergency units and other hospital departments where doctors are not necessarily cardiac specialists.

The DigiScope is designed to be used by doctors in exactly the same way as they use a conventional stethoscope. They position the end piece, in turn, on four different places on the patient’s chest. However, with the DigiScope these four separate sounds are then transmitted wirelessly to a laptop or desktop and synchronised by the QMUL technology as if they were all transmitted simultaneously. They are then analysed using ICA.

With the new system, doctors can compare the visual graphs produced with ‘normal’ readings while the patient is there, or save the graphs and study them later. Or a second opinion on the data can be obtained, via the internet, from another doctor located miles away.

“It’s the multidisciplinary character of this exciting international collaboration that has enabled it to produce such a promising outcome,” says Professor Plumbley. “Two prototype DigiScopes are already in use to test their capabilities. The development will not remove the need for specialist cardiac units, it will simply make it easier to identify potential heart problems at an earlier stage.”

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Notes for Editors

The overall DigiScope initiative is a three-year, £120,000 project funded by the Fundação para a Ciência e Tecnologia (the Portuguese equivalent of the EPSRC).

The project is benefiting from additional co-operation from Brazil’s Real Hospital Português in Recife.

The QMUL work has been undertaken as part of the 5-year ‘Machine Listening Using Sparse Representations’ project, which is receiving EPSRC funding of just over £1.2M.

About the DigiScope: in the ears of an experienced physician, a stethoscope yields important clinical information which can help an initial assessment of a patient’s clinical condition and guide the subsequent need for more specialised examinations. This is particularly true in chest medicine (i.e. cardiology and pneumology), which is the reason why stethoscopes still maintain a key position in medicine in the modern era. However, auscultation (listening to internal sounds within the body via a stethoscope) is a hard skill to master. Heart sounds are of low frequency and the intervals between events are in the order of milliseconds, requiring significant practice for a human ear to distinguish the subtle changes between a normal and a pathological heart sound. The use of a digitally enhanced stethoscope, to train physicians to improve their basic skills in diagnosing and treating heart conditions, or as a tool for worldwide screening of specific heart pathologies, is an example of how state-of-the-art technology can be used to benefit people whatever socio-economic group they belong to and wherever they live. This drives the key objective of the DigiScope project: to develop the prototype of a digitally enhanced stethoscope, capable of automatically extracting clinical features from the collected data as well as providing a clinical second opinion on specific heart pathologies. The Principal Investigator is Miguel Tavares Coimbra, Assistant Professor in the Faculty of Science at the University of Porto. For more information see http://www.digiscope.up.pt

EPSRC is the main UK government agency for funding research and training in engineering and the physical sciences, investing more than £850 million a year in a broad range of subjects – from mathematics to materials science, and from information technology to structural engineering. http://www.epsrc.ac.uk

Queen Mary, University of London is one of the UK’s leading research-focused higher education institutions with some 15,000 undergraduate and postgraduate students. Queen Mary has an annual turnover of £220 million, research income worth £61 million, and generates employment and output worth £600 million to the UK economy each year. As a member of the 1994 Group of research-focused universities, Queen Mary has made a strategic commitment to the highest quality of research, but also to the best possible educational, cultural and social experience for its students. http://www.qmul.ac.uk/

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